Care Planning and Goal Setting Questions

Assessment only helps the patient if it turns into a plan, and a plan only helps if it is followed and reviewed. Care planning ties this whole section together, and the CBT tests whether you understand the process, write goals that can actually be evaluated, and keep the plan alive.

The nursing process

Care planning follows a cycle, usually summarised as assess, plan, implement, evaluate. You assess the patient’s needs, plan the care and set goals, put the plan into action, and evaluate whether it worked, then adjust. Some versions add a diagnosis stage. The important idea is that it is a loop, not a single pass, because a patient’s needs change as their condition does.

SMART goals

Goals are only useful if you can tell whether they have been met, which is where SMART comes in: specific, measurable, achievable, relevant and time-bound. “Patient will walk to the bathroom with a frame by Friday” is SMART, because you can measure it and know when it is achieved. “Mobilise better” or “improve” cannot be evaluated at all, so they fail as goals. Questions here often ask you to pick the SMART option from a list of vague ones.

Person-centred, not done-to

A care plan reflects what matters to the patient, not only what staff judge best. Person-centred care means shared decision-making: the patient’s priorities sit alongside clinical needs, agreed together. A plan imposed on someone, or decided by ward convenience or the family alone, is neither person-centred nor as effective. Involving the patient is a core expectation of the Code.

A living document

The most common exam theme is that a care plan is not a form you complete once on admission and file away. Needs change, and an unreviewed plan becomes inaccurate and unsafe. Evaluation is built into the process: when a goal is met, you move on; when it is not, you look at why and revise the plan or the goal. Ignoring an unmet goal, recording it as met, or blaming the patient all defeat the point of planning care at all.

That completes Part B3, assessing needs and planning care. The assessment skills here, recognising need and turning it into a clear, reviewed plan, feed directly into the care delivery chapters that follow.